Intrathecal ziconotide and baclofen provide pain relief in seven patients with neuropathic pain and spasticity: Case reports

European Journal of Physical and Rehabilitation Medicine

Volumn 45, Issue 1, 2009, Pages 61-67

  Saulino, M ^a,f   Burton, A W ^b   Danyo, D A ^c   Frost, S ^d   Glanzer, J ^d   Solanki, D R ^e  

^a THOMAS JEFFERSON UNIVERSITY   (United States)

^b UNIVERSITY OF TEXAS   (United States)

^c Atlanta Spine and Brain Rehabilitation   (United States)

^d Regional Pain Management Center   (United States)

^e UNIVERSITY OF TEXAS MEDICAL BRANCH   (United States)

^f NONE   (United States)

Author keywords

Analgesics; Baclofen; Pain; Ziconotide

Indexed keywords

BACLOFEN; CENTRAL MUSCLE RELAXANT; NEUROPROTECTIVE AGENT; OMEGA CONOTOXIN; OMEGA CONOTOXIN MVIIA;

ADULT; ARTICLE; CASE REPORT; DRUG COMBINATION; FEMALE; HUMAN; MALE; MIDDLE AGED; NEURALGIA; PAIN; PAIN ASSESSMENT; SPASTICITY; TREATMENT OUTCOME;

ADULT; BACLOFEN; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; MALE; MIDDLE AGED; MUSCLE RELAXANTS, CENTRAL; MUSCLE SPASTICITY; NEURALGIA; NEUROPROTECTIVE AGENTS; OMEGA-CONOTOXINS; PAIN; PAIN MEASUREMENT; TREATMENT OUTCOME;

EID: 67650459927     PISSN: 19739087     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (41)

1. Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization study in primary care. JAMA 1998;280:147-151 (Pubitemid 28498386)
2. Ward AB, Kadies M. The management of pain in spasticity. Disabil Rehabil 2002;24:443-453 (Pubitemid 34649563)
3. Loubser PG, Akman NM. Effects of intrathecal baclofen on chronic spinal cord injury pain. J Pain Symptom Manage 1996;12:241-247 (Pubitemid 26339155)
4. Chou R, Peterson K, Helfand M. Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. J Pain Symptom Manage 2004;28:140-175 (Pubitemid 38970077)
5. Simpson DM, Gracies JM, Graham HK, Miyasaki JM, Naumann M, Russman B et al. Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2008;70:1691-1698
6. Saulino M, Jacobs BW. The pharmacological management of spasticity. J Neurosci Nurs 2006;38:456-459
7. Semenchuk MR, Sherman S. Effectiveness of tizanidine in neuropathic pain: an open-label study. J Pain 2000;1:285-292
8. Murphy NA, Irwin MC, Hoff C. Intrathecal baclofen therapy in children with cerebral palsy: efficacy and complications. Arch Phys Med Rehabil 2002;83:1721-1725 (Pubitemid 35424693)
9. Vender JR, Hughes M, Hughes BD, Hester S, Holsenback S, Rosson B. Intrathecal baclofen therapy and multiple sclerosis: outcomes and patient satisfaction. Neurosurg Focus 2006;21:1-4.
10. Francisco GE. The role of intrathecal baclofen therapy in the upper motor neuron syndrome. Eura Medicophys 2004;40:131-143 (Pubitemid 38787427)
11. Guillaume D, Van Havenbergh A, Vloeberghs M, Vidal J, Roeste G. A clinical study of intrathecal baclofen using a programmable pump for intractable spasticity. Arch Phys Med Rehabil 2005;86:2165-2171 (Pubitemid 41566214)
12. LIORESAL®[package insert]. Minneapolis, MN: Medtronic, Inc.; 2002.
13. Chabal C, Jacobson L, Terman G. Intrathecal fentanyl alleviates spasticity in the presence of tolerance to intrathecal baclofen. Anesthesiology 1992;76:312-314
14. Chabal C, Jacobson L, Schwid HA. An objective comparison of intrathecal lidocaine versus fentanyl for the treatment of lower extremity spasticity. Anesthesiology 1991;74:643-646
15. Dahm PO, Nitescu PV, Appelgren LK, Curelaru II. Long-term intrathecal (i.t.) infusion of bupivacaine relieved intractable pain and spasticity in a patient with multiple sclerosis. Eur J Pain 1998;2:81-85 (Pubitemid 28248323)
16. Middleton JW, Siddall PJ, Walker S, Molloy AR, Rutkowski SB. Intrathecal Clonidine and baclofen in the management of spasticity and neuropathic pain following spinal cord injury: a case study. Arch Phys Med Rehabil 1996;77:824-826 (Pubitemid 26262384)
17. Bhalani M, Lombardi C, Ramirez C, Mobley T, Satia SS. Intrathecal baclofen and bupivacaine combination therapy for spasticity with neuropathic pain in spinal cord injuries: a case series [Poster 300]. Arch Phys Med Rehab 2007;88:E98.
18. Zuniga RE, Perera S, Abram SE. Intrathecal baclofen: a useful agent in the treatment of well-established complex regional pain syndrome. Reg Anesth Pain Med 2002;27:90-93 (Pubitemid 34093285)
19. Gatscher S, Becker R, Uhle E, Bertalanffy H. Combined intrathecal baclofen and morphine infusion for the treatment of spasticity related pain and central deafferentiation pain. Acta Neurochir Suppl 2002;79:75-76
20. Zuniga RE, Schlicht CR, Abram SE. Intrathecal baclofen is analgesic in patients with chronic pain. Anesthesiology 2000;92:876-880 (Pubitemid 30130195)
21. th Annual Meeting of the North American Neuromodulation Society; December 11, 2007; Acapulco, Mexico.
22. Sadiq SA, Poopatana CA. Intrathecal baclofen and morphine in multiple sclerosis patients with severe pain and spasticity. J Neurol 2007;254:1464-1465 (Pubitemid 350112332)
23. Anastassiou E. Combined intrathecal baclofen, morphine and Clonidine infusion for complex pain syndromes due to spasticity. Reg Anesth Pain Med 2005;30:44.
24. Gerber HR. Intrathecal morphine for chronic benign pain. Best Pract Res Clin Anaesthesiol 2003;17:429-442 (Pubitemid 38950006)
25. Ridgeway B, Wallace M, Gerayli A. Ziconotide for the treatment of severe spasticity after spinal cord injury. Pain 2000;85:287-289 (Pubitemid 30110771)
26. PRIALT® [package insert]. San Diego, CA: Elan Pharmaceuticals, Inc.; 2007.
27. PRIALT® Summary of Product Characteristics. Shannon, County Clare, Ireland: Elan Pharma International Ltd., 2005.
28. Bowersox SS, Luther R. Pharmacotherapeutic potential of omegaconotoxin MVIIA (SNX-111), an N-type neuronal calcium channel blocker found in the venom of Conus magus. Toxicon 1998;36:1651-1658 (Pubitemid 28511080)
29. Deer T, Krames ES, Hassenbusch SJ, Burton A, Caraway D, Du Pen S et al. Polyanalgesic Consensus Conference 2007: recommendations for the management of pain by intrathecal (intraspinal) daig delivery: report of an interdisciplinary expert panel. Neuromodulation 2007; 10:300-328
30. Rauck RL, Wallace MS, Leong MS, MineHart M, Webster LR, Charapata SG et al. A randomized, double-blind, placebo-controlled study of intrathecal ziconotide in adults with severe chronic pain. J Pain Symptom Manage 2006;31:393-406.
31. Staats PS, Yearwood T, Charapata SG, Presley RW, Wallace MS, Byas-Smith M et al. Intrathecal ziconotide in the treatment of refractory pain in patients with cancer or AIDS: a randomized controlled trial. JAMA 2004;291:63-70.
32. Wallace MS, Charapata SG, Fisher R, Byas-Smith M, Staats PS, Mayo M et al. Intrathecal ziconotide in the treatment of chronic nonmalignant pain: a randomized, double-blind, placebo-controlled clinical trial. Neuromodulation 2006;9:75-86.
33. Ellis DJ, Dissanayake S, McGuire D, Charapata SG, Staats PS, Wallace MS et at. Continuous intrathecal infusion of ziconotide for treatment of chronic malignant and nonmalignant pain over 12 months: a prospective, open-label study. Neuromodulation 2008;11:40-49
34. Wallace MS, Rauck R, Fisher R, Charapata SG, Ellis D, Dissanayake S et al. Intrathecal ziconotide for severe chronic pain: safety and tolerability results of an open-label, long-term trial. Anesth Analg 2008;106:628-637
35. Saulino M. Successful reduction of neuropathic pain associated with spinal cord injury via of a combination of intrathecal hydromorphone and ziconotide: a case report. Spinal Cord 2007;45:749-752 (Pubitemid 350071053)
36. Sitaram BR, Tsui M, Rawicki HB, Lam S, Sitaram M. Stability and compatibility of intrathecal admixtures containing baclofen and high concentrations of morphine. Int J Pharmaceutics 1997;153:13-24. (Pubitemid 27283330)
37. Alvarez JC, De Mazancourt P, Chartier-Kastler E, Denys P. Drug stability testing to support clinical feasibility investigations for intrathecal baclofen-clonidine admixture. J Pain Symptom Manage 2004;28:268-272 (Pubitemid 39158809)
38. Shields D, Montenegro R, Ragusa M. Chemical stability of admixtures combining ziconotide with morphine or hydromorphone during simulated intrathecal administration. Neuromodulation 2005;8:257-263 (Pubitemid 43942736)
39. Shields D, Montenegro R, Aclan J. Chemical stability of an admixture combining ziconotide and bupivacaine during simulated intrathecal administration. Neuromodulation 2007;10(Suppl 1):1-5. (Pubitemid 47481091)
40. Shields D, Montenegro R. Chemical stability of ziconotide-clonidine hydrochloride admixtures with and without morphine sulfate during simulated intrathecal administration. Neuromodulation 2007;10(Suppl 1):6-11. (Pubitemid 47481090)
41. Shields D, Montenegro R, Aclan J. Chemical stability of admixtures combining ziconotide with baclofen during simulated intrathecal administration. Neuromodulation 2007;10(Suppl 1):12-17 (Pubitemid 47481092)